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Endocrinology > Types of Diabetes > Flashcards

Types of Diabetes Flashcards

1
Q

what type of cells what insulin

A

beta cells, islets of langerhans

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2
Q

what type of diabetes has sweet smelling urine

A

mellitus (greek for honey)

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3
Q

what do all types of diabetic share

A

an inability to maintain glucose homeostasis (due to either failure of insulin synthesis, release or activity)

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4
Q

what diabetes is RELATIVE not absolute deficiency

A

type 2

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5
Q

what is diabetes mellitus

A

group of metabolic diseases characterised by hyperglycemia resulting from defects in insulin secretion, action or both

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6
Q

what is abnormal blood glucose

A

> 6.1 mmol/L but really more like >5.6 mmol/L

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7
Q

what is the diagnostic criteria for diabetes

A

*impaired or pre diabetes

HbA1c >48 m/m (42-47m/m*)

fasting glucose >7 mmol/L (6.1-6.9mmol/L*)

2 hour glucose in OGTT >11.1 mmol/L (7.8-11.0 mmol/m)

random glucose >11.1mmol/L

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8
Q

what is the normal ranges for blood glucose

A

3.3 - 5.8 mmol/L

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9
Q

what is type 1 diabetes

A

autoimmune disease resulting in beta cell destruction, usually leading to absolute insulin deficiency

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10
Q

what is type 2 diabetes

A

progressive loss of beta-cell insulin secretion (causing hyperinsulinaemia) frequently on the background of insulin resistance

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11
Q

what is gestation diabetes mellitus

A

Any degree of glucose intolerance arising or diagnosed during pregnancy

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12
Q

what is MODY

A

maturity onset diabetes of the young

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13
Q

what antibodies re usually found in T1DM

A

anti-GAD/ anti- islet cell antibodies

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14
Q

what might be seen histologically in T1DM

A

insulitis- lymphocytic infiltrate

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15
Q

what is the typical presentation of type 1 diabetes

A 
pre school and peri puberty 
small peak in late 30's
usually lean 
acute onset 
severe symptoms 
severe weight loss 
ketonuria +/- metabolic acidosis 
no evidence of microvascular disease at diagnosis 
immediate and permanent requirement for insulin
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16
Q

what are the risk factors for type 2 diabetes

A 
obesity (central)
familial 
race 
CVD
gestational diabetes
hypertension 
high cholesterol/ triglyceride 
polycystic ovary syndrome 
inactivity 
medications (antipyschotics)
17
Q

when should all patients get tested for diabetes

A

45 years

18
Q

how do you test for type 2 diabetes

A

fasting glucose, 2-hr plasma glucose during 75 g oral glucose tolerance test, A1C

19
Q

what are the symptoms of diabetes mellitus

A 
thirst 
polyuria 
thrush 
weakness fatigue 
blurred vision
infections 
weight loss 
T2DM- complications- neuropathy, retinopathy
20
Q

what discriminatory tests can be used

A

autoimmune markers- anti-GAD, anti insulin, anti tyrosin phosphatases

ketones
C peptide

in type 1 there is a strong HLA association

21
Q

what is LADA and how do you distinguish it from T1DM

A

latent autoimmune diabetes of adults. type of diabetes mellitus with later onset than type 1

ketosis= type 1

22
Q

do people with idiopathic T1DM have B cell autoimmunity

A

no

23
Q

is idiopathic T1DM HLA associated

A

no, but strongly inherited

24
Q

what is type three diabetes

A

gestational

25
Q

what is type 4 diabetes

A 
can arise from:
drug induced 
abnormalities of insulin and its receptor 
genetic diseases 
pancreatic disease
endocrine disease
26
Q

what pancreatic diseases can cause type 4 diabetes

A

chronic/ recurring pancreatitis (gall stones/ alcohol)
haemochromatosis
cystic fibrosis

27
Q

what endocrine diseases can cause type 4 diabetes

A

cushings syndrome
acromegaly
phaechromocytoma
glucagonoma

28
Q

what drugs can cause type 4 diabetes

A

glucocorticoids
diuretics
b blockers

29
Q

what genetic diseases can cause type 4 diabetes

A

cystic fibrosis
myotonic dystrophy
turners syndrome

30
Q

what should you look out for which would suggest monogenic diabetes

A 
Strong Family History
Associated Features (renal cysts etc)
Young Onset
GAD-negative
C-peptide positive
31
Q

what does HbA1c show

A

measure of glucose control over the past 2-3 months

32
Q

what are the complications of diabetes

A

macro-vascular: heart disease, storke, CVD, atheroma

micro-Vascular: retinopathy (blindness), nephropathy (kidney failure), neuropathy- foot ulcers (charcots foot)

psychiatry/ psychology

33
Q

which test is diagnostic of diabetes

A

fasting blood glucose

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